{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:50:41Z","timestamp":1792176641039,"version":"4.4.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The aim of this study was to evaluate the outcomes of Gamma Knife surgery (GKS) when used for patients with intractable cluster headache (CH).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Four participating centers of the North American Gamma Knife Consortium identified 17 patients who underwent GKS for intractable CH between 1996 and 2008. The median patient age was 47 years (range 26\u201383 years). The median duration of pain before GKS was 10 years (range 1.3\u201340 years). Seven patients underwent unsuccessful prior surgical procedures, including microvascular decompression (2 patients), microvascular decompression with glycerol rhizotomy (2 patients), deep brain stimulation (1 patient), trigeminal ganglion stimulation (1 patient), and prior GKS (1 patient). Fourteen patients had associated autonomic symptoms. The radiosurgical target was the trigeminal nerve (TN) root and the sphenopalatine ganglion (SPG) in 8 patients, only the TN in 8 patients, and only the SPG in 1 patient. The median maximum TN and SPG dose was 80 Gy.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Favorable pain relief (Barrow Neurological Institute Grades I\u2013IIIb) was achieved and maintained in 10 (59%) of 17 patients at a median follow-up of 34 months. Three patients required additional procedures (repeat GKS in 2 patients, hypothalamic deep brain stimulation in 1 patient). Eight (50%) of 16 patients who had their TN irradiated developed facial sensory dysfunction after GKS.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Gamma Knife surgery for intractable, medically refractory CH provided lasting pain reduction in approximately 60% of patients, but was associated with a significantly greater chance of facial sensory disturbances than GKS used for trigeminal neuralgia.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.3.jns091843","type":"journal-article","created":{"date-parts":[[2010,4,30]],"date-time":"2010-04-30T14:15:20Z","timestamp":1272636920000},"page":"1736-1743","source":"Crossref","is-referenced-by-count":38,"title":["Stereotactic radiosurgery for intractable cluster headache: an initial report from the North American Gamma Knife Consortium"],"prefix":"10.3171","volume":"114","author":[{"given":"Hideyuki","family":"Kano","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Universit\u00e9 de Sherbrooke, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Stafford","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Flannery","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns091843","series-title":"Neurology","first-page":"354","article-title":"Cluster headache: a prospective clinical study with diagnostic implications","volume":"58","author":"Bahra","year":"2002"},{"key":"b2-jns091843","series-title":"Neurosurgery","first-page":"1164","article-title":"A new classification for facial pain","volume":"53","author":"Burchiel","year":"2003"},{"key":"b3-jns091843","series-title":"Acta Anaesthesiol Belg","first-page":"101","article-title":"Cluster headache and sphenopalatine block","volume":"32","author":"Devoghel","year":"1981"},{"key":"b4-jns091843","series-title":"Neurosurgery","first-page":"1252","article-title":"Trigeminal nerve radiosurgical treatment in intractable chronic cluster headache: unexpected high toxicity","volume":"59","author":"Donnet","year":"2006"},{"key":"b5-jns091843","series-title":"J Neurol Neurosurg Psychiatry","first-page":"218","article-title":"Gamma knife treatment for refractory cluster headache: prospective open trial","volume":"76","author":"Donnet","year":"2005"},{"key":"b6-jns091843","series-title":"Cephalalgia","first-page":"135","article-title":"Latent dysautonomic pupillary lateralization in cluster headache. 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